SELECT SPECIALTY HOSPITAL - FORT WAYNE INC (NPI# 1104825140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104825140 |
| Entity Type | Organization |
| Organization Name | SELECT SPECIALTY HOSPITAL - FORT WAYNE INC |
| Practice Address |
700 Broadway 7th Fl East Fort Wayne IN 46802-1402 |
| Mailing Address |
4714 Gettysburg Rd Legal Dept. Mechanicsburg PA 17055-4325 |
| Practice Telephone | 2604253811 |
| Practice Fax Number | 2604253812 |
| Mailing Telephone | 7179721100 |
| Mailing Fax Number | 7179759981 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2010-09-02 |
| Authorized Official Name | MR. MICHAEL E. TARVIN (VICE PRESIDENT) |
| Authorized Official Telephone | 7179721100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282E00000X | Long Term Care Hospital | 009856 | IN | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | BCBS IN | 000000246982 | 01 |
| Street Address |
700 BROADWAY 7TH FL EAST |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46802-1402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598395238 | Werner R Wolff | Nurse Practitioner | 700 Broadway, Fort Wayne, IN 46802-1402 | 2020-01-22 |
| 1477114312 | Mandy Onguta | Nurse Practitioner | 700 Broadway, Fort Wayne, IN 46802-1402 | 2019-06-21 |
| 1609386416 | Kelly Marie Snyder | Occupational Therapy Assistant | 700 Broadway, Fort Wayne, IN 46802-1402 | 2017-10-06 |
| 1851759922 | Faysal Massarweh | Internal Medicine | 700 Broadway, Fort Wayne, IN 46802-1402 | 2016-02-04 |
| 1689041451 | Christine Montanaro | Registered Nurse | 700 Broadway, Fort Wayne, IN 46802-1402 | 2015-08-28 |
| 1265825178 | Mary Bullis | Nurse Practitioner | 700 Broadway, Fort Wayne, IN 46802-1402 | 2015-03-17 |
| 1366883068 | Niroshan Kirupananthan | Internal Medicine | 700 Broadway, Fort Wayne, IN 46802-1402 | 2013-07-10 |
| 1548552375 | Musa Abdalla | Family Medicine | 700 Broadway, Fort Wayne, IN 46802-1402 | 2011-05-12 |
| 1366754616 | Darnell J Brown | Surgery | 700 Broadway, Fort Wayne, IN 46802-1402 | 2010-07-01 |
| 1962722991 | Lutheran Health Network | General Acute Care Hospital | 700 Broadway, Fort Wayne, IN 46802-1402 | 2010-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084416 | Renaissance Counseling Center,llc | Community/Behavioral Health | 1210 Guthrie St, Fort Wayne, IN 46802 | 2020-05-14 |
| 1699260182 | Tina Huffman Counseling Services LLC | Clinic/Center | 2323 111 W. Berry St., Fort Wayne, IN 46802 | 2018-06-27 |
| 1669879664 | Neighborhood Health Clinics, Inc | Clinic/Center | 1721 S Calhoun St, Fort Wayne, IN 46802 | 2014-11-20 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1174899405 | Hearcare Connection, Inc. | Audiologist | 130 W Main St Ste 150, Fort Wayne, IN 46802 | 2012-03-30 |
| 1801114533 | Hoosier Sports & Chiropractic LLC | Chiropractor | 122 W Wayne Street, Fort Wayne, IN 46802 | 2010-05-05 |
| 1891912523 | Krista Lohmar | Speech-Language Pathologist | 3340 North Washington Road, Ft. Wayne, IL 46802 | 2007-04-20 |
| 1811047608 | Catholic Charities of The Diocese of Fort Wayne-south Bend, Inc. | Counselor | 915 South Clinton, Fort Wayne, IN 46802 | 2007-01-12 |
| 1548323801 | Clifford T Salk | Dentist | 122 W Washington Blvd, Fort Wayne, IN 46802 | 2006-12-18 |
| 1720155492 | Kristina Wise | Social Worker | 203 W Wayne St Ste 317, Fort Wayne, IN 46802 | 2006-11-29 |
| Find all providers in zip 46802 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174673636 | Vibra Hospital of Fort Wayne, LLC | Long Term Care Hospital | 2200 Randallia Dr, 5th Floor, Fort Wayne, IN 46805-4638 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215341391 | Indiana University Health Inc. | Long Term Care Hospital | 550 University Blvd Rm 3145, Indianapolis, IN 46202-5149 | 2014-06-17 |
| 1336499599 | Gregg Scott Shepherd | Long Term Care Hospital | 1075 W Cr 300 North, New Castle, IN 47362 | 2012-09-14 |
| 1174710750 | Physicians Hospital, LLC | Long Term Care Hospital | 1625 E Jefferson Blvd, Mishawaka, IN 46545-7103 | 2007-09-27 |
| 1871613398 | Northern Indiana Health Care System | Long Term Care Hospital | 45 E Miller Rd, La Fontaine, IN 46940-9292 | 2007-03-29 |
| 1104991447 | Deanna Lynne Harrington | Long Term Care Hospital | 3025 W Sycamore St, Kokomo, IN 46901-4176 | 2006-11-22 |
| 1558446021 | Kindred Hospitals Limited Partnership | Long Term Care Hospital | 1700 W 10th St, Indianapolis, IN 46222-3802 | 2006-10-25 |
| 1417032996 | Transitional Hospitals Corporation of Indiana, Inc. | Long Term Care Hospital | 607 Greenwood Springs Drive, Greenwood, IN 46143-1407 | 2006-10-25 |
| 1114972502 | St. Vincent Seton Specialty Hospital, Inc. | Long Term Care Hospital | 8050 Township Line Road, Indianapolis, IN 46260-1902 | 2006-05-23 |
| 1063414886 | Regency Hospital of Northwest Indiana, LLC | Long Term Care Hospital | 4321 Fir St, 4th Floor, East Chicago, IN 46312-3049 | 2005-08-11 |
| 1720087620 | Select Specialty Hospital - Indianapolis Inc | Long Term Care Hospital | 898 E Main St, Greenwood, IN 46143-1407 | 2005-07-21 |
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| City | FORT WAYNE |
| Zip Code | 46802 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.